| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| E1390 |
Oxygen concentrator |
22,198 |
22,175 |
$704K |
| E0603 |
Electric breast pump |
2,308 |
2,298 |
$283K |
| A9276 |
Disposable sensor, cgm sys |
584 |
558 |
$169K |
| E0601 |
Cont airway pressure device |
3,914 |
3,907 |
$118K |
| E0143 |
Walker folding wheeled w/o s |
3,185 |
3,174 |
$108K |
| A4239 |
Non-adju cgm supply allow |
1,101 |
1,084 |
$95K |
| E0431 |
Portable gaseous 02 |
7,300 |
7,263 |
$78K |
| E0260 |
Hosp bed semi-electr w/ matt |
1,179 |
1,172 |
$63K |
| E0570 |
Nebulizer with compression |
5,594 |
5,572 |
$60K |
| K0001 |
Standard wheelchair |
4,318 |
4,301 |
$57K |
| E0470 |
Rad w/o backup non-inv intfc |
1,087 |
1,085 |
$46K |
| E1392 |
Portable oxygen concentrator |
6,403 |
6,399 |
$41K |
| A7030 |
Cpap full face mask |
1,378 |
1,374 |
$40K |
| K0738 |
Portable gas oxygen system |
6,381 |
6,370 |
$40K |
| E0255 |
Hospital bed var ht w/ mattr |
2,435 |
2,432 |
$36K |
| E0114 |
Crutch underarm pair no wood |
1,346 |
1,342 |
$34K |
| K0003 |
Lightweight wheelchair |
1,529 |
1,521 |
$33K |
| A7031 |
Replacement facemask interfa |
1,253 |
1,243 |
$31K |
| K0553 |
Ther cgm supply allowance |
320 |
308 |
$31K |
| A4253 |
Blood glucose/reagent strips |
814 |
782 |
$29K |
| B4035 |
Enteral feed supp pump per d |
247 |
234 |
$24K |
| E0562 |
Humidifier heated used w pap |
1,008 |
1,006 |
$24K |
| A7034 |
Nasal application device |
930 |
928 |
$20K |
| B4152 |
Ef calorie dense>/=1.5kcal |
266 |
253 |
$20K |
| E0630 |
Patient lift hydraulic |
720 |
716 |
$16K |
| A7035 |
Pos airway press headgear |
1,492 |
1,487 |
$11K |
| A4604 |
Tubing with heating element |
1,989 |
1,987 |
$11K |
| E0607 |
Blood glucose monitor home |
259 |
257 |
$10K |
| E0149 |
Heavy duty wheeled walker |
637 |
635 |
$9K |
| L1830 |
Ko immob canvas long pre ots |
196 |
196 |
$9K |
| A7032 |
Replacement nasal cushion |
253 |
252 |
$8K |
| A7038 |
Pos airway pressure filter |
2,623 |
2,473 |
$8K |
| K0195 |
Elevating whlchair leg rests |
1,508 |
1,503 |
$8K |
| A7005 |
Nondisposable nebulizer set |
672 |
670 |
$7K |
| L4360 |
Pneumat walking boot pre cst |
43 |
42 |
$6K |
| B9002 |
Enter nutr inf pump any type |
154 |
150 |
$5K |
| E2103 |
Non-adju cgm receiver/mon |
41 |
41 |
$4K |
| A4259 |
Lancets per box |
681 |
659 |
$4K |
| A4385 |
Ost skn barrier sld ext wear |
115 |
112 |
$3K |
| E2601 |
Gen w/c cushion wdth < 22 in |
133 |
132 |
$3K |
| A7046 |
Repl water chamber, pap dev |
1,021 |
1,021 |
$2K |
| A7037 |
Pos airway pressure tubing |
113 |
113 |
$2K |
| L3908 |
Who cock-up nonmolde pre ots |
47 |
40 |
$2K |
| A7033 |
Replacement nasal pillows |
69 |
68 |
$1K |
| E0776 |
Iv pole |
231 |
218 |
$1K |
| B4034 |
Enter feed supkit syr by day |
57 |
56 |
$987.18 |
| L4350 |
Ankle control ortho pre ots |
12 |
12 |
$705.01 |
| E0600 |
Suction pump portab hom modl |
38 |
38 |
$628.94 |
| E0256 |
Hospital bed var ht w/o matt |
26 |
25 |
$586.32 |
| E0978 |
W/c acc,saf belt pelv strap |
109 |
108 |
$487.57 |
| A4456 |
Adhesive remover, wipes |
119 |
112 |
$424.46 |
| E0156 |
Walker seat attachment |
55 |
55 |
$323.21 |
| A5120 |
Skin barrier, wipe or swab |
67 |
66 |
$268.92 |
| E0990 |
Wheelchair elevating leg res |
14 |
14 |
$91.47 |
| A7003 |
Nebulizer administration set |
193 |
193 |
$85.58 |
| A7013 |
Disposable compressor filter |
477 |
476 |
$17.27 |